<div class="editor-form" style="padding: 20px;">
    <table style="text-align:center;">
        <tr>
            <td colspan="3" class="m13y-field1-cell">
                是否闭经
                <select id="form-menst-9">
                    <option value="1">未闭经</option>
                    <option value="0">已闭经</option>
                </select>
            </td>
        </tr>
        <tr>
            <td>初潮年龄<input id="form-menst-1" class="m13y-field-number" type="number"></td>
            <td>
                <div>
                    月经持续
                    <input id="form-menst-2" type="number" class="m13y-field-number">
                    ~
                    <input id="form-menst-3" type="number" class="m13y-field-number">
                </div>
                <div style="width: 200px;border:1px solid #000"></div>
                <div>
                    生理周期
                    <input id="form-menst-4" type="number" class="m13y-field-number">
                    ~
                    <input id="form-menst-5" type="number" class="m13y-field-number">
                </div>
            </td>
            <td>
                <input id="form-menst-7" type="number" class="m13y-field-number">
                <input id="form-menst-6" type="date" class="m13y-field-date">
            </td>
        </tr>
    </table>
</div>